Refer to local protocols for emergency medical services (EMS) management. Atrial flutter in an unstable patient should be treated immediately with synchronized cardioversion . Unstable patients are those with ongoing chest pain, severe shortness of breath, altered level of consciousness, or hypotension.
Read moreHow is stable atrial flutter treated?
Initial treatment of atrial flutter targets the rate control (which is frequently ~150 BPM). Drugs of choice include beta blockers such as esmolol (0.5 mg/kg IV bolus followed by 50-300 ucg/kg/min) and propranolol, or calcium channel blockers such as verapamil (5-10 mg IV) or diltiazem.
Read moreIs anticoagulation needed for atrial flutter?
Most patients with atrial flutter should be considered for chronic anticoagulation in a manner similar to those with atrial fibrillation (AF). This recommendation is based not only on the fact atrial flutter carries a risk for systemic embolization but also that these patients usually have episodes of AF.
Read moreWhich beta-blocker is best for atrial flutter?
Bisoprolol* or metoprolol succinate are first-choice beta-blockers for patients with atrial fibrillation as they are prescribed once-daily and do not require dose adjustment in patients with renal impairment. Bisoprolol is preferred as it is more cardioselective than metoprolol and may cause more bradycardia.21 Tem 2017
Read moreWhen do you use digoxin in AF?
Digoxin is indicated in patients with heart failure and reduced left ventricular function . A large study of elderly persons with nonvalvular AF or atrial flutter indicated that digoxin therapy can increase the risk that a patient will die within approximately 3 years by more than 20%.18 Kas 2019
Read moreWhat arrhythmias does digoxin treat?
Digoxin is an appropriate drug for controlling the ventricular response rate to atrial fibrillation in association with diastolic heart failure, as the onset of this arrhythmia may cause marked symptomatic deterioration. Digoxin is indicated for the management of heart failure.
Read moreDoes atrial flutter require anticoagulation?
Most patients with atrial flutter should be considered for chronic anticoagulation in a manner similar to those with atrial fibrillation (AF). This recommendation is based not only on the fact atrial flutter carries a risk for systemic embolization but also that these patients usually have episodes of AF.
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